by Beth Blevins
“Come to supper!” is the invitation extended recently by the Virginia State Office of Rural Health (VA SORH). As a result, folks across rural Virginia have gathered to eat barbecue and discuss what is going on in their communities.
“We figure that people relax when they are eating, and that the conversation will flow a little freer than it would if someone is standing up in front of the room and asking questions,” said Heather Anderson, VA SORH Director.
The community suppers, based on the World Cafe method, sprang out of the SORH’s efforts to update the Virginia Rural Health Plan (VRHP), Anderson said. “We know what the data says, but we don’t know what is working in a community necessarily,” she said. “We wanted to hear from people we don’t always hear from—and who typically don’t get to hear from one another.”
“We already have access to people in the healthcare system since we work with hospitals and providers,” she continued. This time, she said, they wanted to hear from school district personnel, mental health professionals, business owners, and patients.
“We are trying to get beyond our typical healthcare sphere to make this a community-driven project,” she said. “We want to spark community involvement, collaborate where we are needed, and ultimately empower the communities to improve their health status.”
The suppers have been held “in places that reduce barriers,” Anderson said. “We don’t want it to be at the hospital necessarily but at the VFW or the library or a church, if that’s where the community gathers.”
They use local food, served by a community group, as a way of giving back to the community. “Since the first meetings have been held in Southwest Virginia, the local food has been barbecue,” she said. “Maybe by the time we get to Accomack (on the Eastern Shore) it will be seafood!”
The counties where the suppers are held (seen in purple on the state map, right) were chosen by using several data points, including Appalachian Regional Commission’s distressed county index, the Robert Wood Johnson Foundation’s County Health Rankings, and the Virginia Health Opportunity Index (HOI). “We felt like that gave us a state, national, and regional look at Virginia,” she explained.
Then they took the data, ranked the areas where they knew they wanted to go, and asked themselves, “where are we missing?” and “how can we engage the small business owner on Main Street and get their perspective?” Anderson said. “As the SORH, we want to learn what is working for the community, the hidden gems, not just what isn’t working, which is what the traditional data looks at. That’s how we could include a place like Amelia County, which is in the shadows of Richmond, but is still very rural. There are areas that get overlooked because they may not meet the federal definition of rural, but we consider them rural.”
As community members gather for supper, they are given the same three questions to discuss among themselves at each table: “Name one to two things that will improve the health of your community; what are the good things about your community; and what is wellness and what does it look like here,” Anderson said. “At the end we bring it all together with a local facilitator. The expectation is that we want to hear local things we might not have heard before.”
The community suppers so far have had an average of 30 people in the room, with a total of 120 participants. The conversations are being funded with Flex carry-forward funds, with SORH funds likely picking up some of the sustainability going forward, such as printing resource documents to distribute.
Anderson said that one thing they have learned already from the suppers is how faith communities are filling in service gaps in rural Virginia. “In Wythe County, we learned there’s a very strong food bank that’s been around for 20 some years that has blossomed into clothing and social services for people,” she said. “I don’t know that we would have found that out if we hadn’t had the opportunity to have these conversations.”
VA SORH is gathering so much information from the suppers that they will be using it beyond the creation of the VRHP, by sharing information about best practices and community champions in the areas they have visited, Anderson said. “Our SORH will take the qualitative information and promote a champion, either a person or an agency, on a monthly basis on our website,” she said.
“We’re hearing really wonderful things about the communities,” Anderson said. “We know they are lacking transportation, there’s an opioid epidemic, there aren’t enough providers. But we don’t always know what is working well—we are trying to get that out of these conversations. We’re trying to get people in the room that need to talk to each other. Sometimes we make things too complicated, and miss the boat by not talking to people.”